A 19-year-old male patient, referring with fatigue, sweating and fever for one week, hospitalized. His general condition was moderate, conscious, and fever was 38.3oC/axillary, blood pressure was 100/60 mmHg, pulse rate was 72/min. Rusty tongue and splenomegaly was detected in his physical examination. Laboratory examination revealed leukocyte 2,500/mm3 (46% lymphocyte), Hb 13.8 gr/dl, Hct 40%, PLT 70,000/mm3, ESR 28/h, CRP 104 mg/l, ALT 40 U/L, AST 39 U/L and Widal test (Salmonella typhi O antigen) 1/160 titer were found to be positive. In this patient, Enteric fever was clinically considered because of febris continue, dicrotic pulse and leucopenia. Ciprofloxacin was started at the dose of 2x500 mg/day orally. His fever complaint improved in 5th day of treatment, and S. typhi grew in blood medium. In 10th day of treatment, his general condition improved dramatically and the laboratory measurements were as follows: leukocyte 6,600/mm3 (23% lymphocyte), PLT 172,000/mm3, ESR 9/h, CRP 1 mg/l, ALT 23 U/L, AST 14 U/L. Over 38oC fever complaint reoccurred. In all clinical and laboratorial investigations conducted on the patient any infection focus which may be the cause of fever wasn’t detected. In 13th day of treatment, as the fever complaint was considered due to ciprofloxacin, the drug was avoided. After 12 hours without ciprofloxacin, his fever improved. Ciprofloxacin related fever is a rare condition. When physicians are investigating the etiology of fever, they should remember that antibiotics may be cause of fever.

Ciprofloxacin Adverse effects of fluoroquinolones Fever